Nestled into the Gloucestershire landscape, in the South West of England, an anonymous-looking building serves as home to a Suicide Crisis Centre and the small army of on-shift heroes who keep it operational 24 hours a day, seven days a week to save lives.
Since opening five years ago, the staff at the Suicide Crisis Centre have saved the lives of every person who has walked through their doors. In total, they’ve prevented hundreds of suicides.
But don’t think their achievement has made them complacent. One person attempts to take their own life every 40 seconds globally, and so, their daily battle to end suicide in their county continues 365 days of the year.
Allan Fawlk, a 60-year-old Gloucester man told UNILAD he had planned and attempted to take his own life after a catastrophic relationship breakdown before seeking the help of the Suicide Crisis Centre.
He explained how their approach helped him through a life-threatening crisis which started when he was 55, with two sons in their twenties, after his wife of three decades left him, revealing an affair she’d kept hidden throughout the marriage.
Describing the relationship breakdown, Allan – Al to his mates – recalled:
It was like a hand grenade had been dropped in the living room, and she was the pin. Then she left and everything exploded.
The aftermath was everything I hadn’t been able to cope with in my life – a baby who died immediately after childbirth, the deaths of my dad and brother in 2001.
[My ex-wife] was the instigator of my downfall but I don’t blame her for what happened next: I just fell apart. A complete and utter nervous breakdown.
Suicide Crisis saved my life. There’s no two ways about it.
The Suicide Crisis Centre didn’t set themselves the goal of zero suicide – an accolade which means every single suicidal person welcomed through their doors in the past five years is still alive today.
Instead, the staff simply decided to do everything in their power for each individual to help them stay alive, and they only celebrate their success retrospectively.
It all began with a woman named Joy, who tried to end her own life more than once back in 2012.
This year, on World Suicide Prevention Day (10 September), Joy Hibbins – the CEO of Suicide Crisis – told UNILAD the thought of creating the Suicide Crisis Centre and providing holistic support to the suicidal kept her alive through a ‘deeply traumatic experience’.
Joy recalled the effects of her own Post-Traumatic Stress Disorder:
Images of the traumatic experience would flash back into my mind repeatedly. I was constantly reliving it. I felt I would never be able to escape what had happened to me.
The psychological impact of it was too much to bear, and within days I descended into suicidal crisis.
The NHS offers advice if you are feeling suicidal, or you’re worried about someone else:
Joy was placed in the hands of the NHS mental health service crisis team but, she says, available support and charity services did not work for her.
Like many people in the depths of a suicide crisis, Joy was visited by a different person every day and found it difficult to build a connection with team members due to the lack of continuity of care.
She’s not alone; 64 per cent of US patients made a healthcare visit within a month of attempting suicide, a 2015 study published in Medical Care found. Clearly there are gaps in the system which need to be addressed as a public health concern.
At a time of suicide crisis when most feel distant and disconnected, Joy found ‘the clinical distance of psychiatric staff’ compounded isolation.
Furthermore, the ‘distraction techniques’ and practical advice – like having a bath or making a cup of tea – fell on deaf ears, as did the promotion of self-determination Joy encountered when she was told repeatedly it was her decision to end her own life.
The sentiment is the medical equivalent of a shrug of the shoulders. It’s an experience too often encountered, says Al, who tried going to two GPs to talk.
Al wanted to tell a professional how he could still remember the face of a stranger who’d taken his own life in front of him, when he was just 14, in a horrific accident which left Al with broken bones and lasting trauma for over a year.
He also wanted to talk about his recent dissociations and his own suicide ideation in adulthood, but his lifelong doctor told him to ‘be strong for his boys’, while another spent the 10-minute appointment looking out of the window and reciting lines from text books before Al left, empty, adrift and feeling more ‘dismissed’ than ever.
During her own crisis, Joy kept herself alive with a new sense of purpose with little help from clinicians, she said:
I think what kept me alive was a realisation that there was a need for a different kind of service for people in crisis. I felt so strongly that it didn’t exist currently and that it had to be set up.
So was born the idea of the charity Suicide Crisis – manifesting Joy’s surprisingly novel idea to offer all-encompassing emotional support to the suicidal in the Suicide Crisis Centre and separate Trauma Centre in Cheltenham.
Loved ones of people with suicidal tendencies are often told to talk, listen and support sufferers back to good mental health – yet the same perceived wisdom doesn’t apply to clinicians offering medical treatment to alleviate suicidal thoughts.
Indeed, one NHS survey found medication is the most common form of mental health treatment, and is more often prescribed than psychological therapy – which is fine for some, but certainly not the answer to every sufferer’s suicidal thoughts.
Joy, who gave evidence to the Health Select Committee which advises the government on best practice, told UNILAD the discussion around treatment and recovery from suicidal thoughts needs to be framed differently.
At the Suicide Crisis Centre the staff – trained counsellors and psychiatric advisers who are chosen for their empathetic qualities, some of whom have lived experience of suicide crisis themselves – have fostered a ‘caring approach’ and woven emotional support into the very fabric of their work.
Joy is convinced this approach is how every life can be saved:
When someone is at the point of suicide, they may have disconnected from the people around them. If they encounter clinical distance, it may leave them feeling equally disconnected.
We need to work proactively to reach and connect with them. Kindness and a caring approach can break through the barriers they have put up around themselves. I learned from my own experience that kindness can be life-saving.
Seeking out a silver lining, Joy credits her own crisis with her ability to help others so effectively by designing this suicide prevention service.
Joy, an Oxford graduate who was diagnosed with bipolar in 2015, elaborated:
I understand on a profound level what it is like to be at the point of suicide. If I had not experienced crisis myself, I would not have understood the vital elements in helping someone stay alive.
It is different from the knowledge gained by a psychiatrist or a professor; the usual people we look to for the answers to zero suicide.
Perhaps we should not be surprised it was a person with lived experience of suicidal crisis who designed a service which has achieved zero suicide.
Al, who received support from Joy via Suicide Crisis, anytime, anywhere – Bank Holiday and Christmas Day included – added:
This is the difference. Joy’s qualification was that she’d lived where I’d lived, she’d stood in my shoes, she’d been where I’d been. She’s more qualified than anyone.
That first meeting, she never stopped me talking. We were talking like we’d known each other forever. I watched the lights go dark outside the room, I watch everybody leave the building.
It was quite eerie, but still she didn’t push me to leave.
Al recalled expecting to meet someone ‘matronly’ when he arrived at the Centre, but was greeted by Joy who he described as ‘fragile’ in appearance.
If there’s anything understanding suicide teaches you, it’s that looks can be deceiving.
Joy’s three-part approach combines the services of the Suicide Crisis Centre, as well as home visits and an emergency phone line, giving more ways to reach someone in crisis.
Joy said her design ‘wraps the client in a kind of safety net’, adding:
This prevents them from falling through the gaps which may exist in other services. If we hadn’t provided emergency home visits to clients at immediate risk of suicide, I do not think all our clients would have survived.
Moreover, unlike some services, the ethos of Suicide Crisis does not emphasise autonomy at such a time.
Joy recounts home visits during which she has been faced with clients in despair wielding weapons against themselves and knows better than most how intervention in crisis can mean saving a life.
Speaking from her own experience of suicide ideation and attempts, she said:
My view is that a person at the point of suicide is almost always either so highly distressed or so unwell at that point they are not thinking as they usually would.
For that reason, we actively intervene to protect them and do everything we can to ensure their survival.
Once the crisis has been averted in those moments of great distress, Suicide Crisis staff continue to provide the person with ongoing daily support until they recover.
Of the times staff members can’t be with clients, Joy explained:
The strong connection we build with clients helps to sustain them even when we are absent. We cannot always be with them 24 hours a day but they often say they feel we are.
Al said it feels as though Joy is ‘in [his] pocket for life’, even in moments of deep darkness.
When his best friend and cousin – who’d encouraged him to seek help after his suicide attempt and supported him through recovery – died of cancer just over a year ago, the staff at Suicide Crisis went to the funeral with Al.
The CEO explained the importance of making clients feel Suicide Crisis staff are always there with clients, particularly in the case of people who go under the radar of other services.
Currently one person every 90 minutes dies by suicide in the UK and approximately two thirds of these are not in contact with mental health services.
But some people who wouldn’t feel comfortable approaching another service do come to the Suicide Crisis Centre for what Joy describes as ‘specialised and targeted support’.
It has always been our aim to reach people who would not usually seek help from any other source and whose silence about their suicidality puts them at great risk.
They tell no one. We read about such cases in the press. Family members and friends say they had no idea the person was at risk.
It’s important to identify signs of potential risk:
Specialised support is particularly important in helping the group most affected by suicide; men in their 30s, 40s and 50s, from lower socio-economic groups.
A high proportion of the Suicide Crisis Centre clients are men, Joy said, ‘despite the general perception that men are less likely to seek help’.
Joy is keen to assert Suicide Crisis’ independence from the NHS and clients’ GPs, saying this is a reason why many men – often at high risk of suicide, who would not have told anyone else about their suicidal ideation – say they feel able to approach the service.
Control is important to their male clients, she said, adding:
Many say they would not tell their GP they are feeling suicidal, for fear of having it on their medical records, concerned it could affect their job prospects. Some also cited pride as a reason for not telling their GP.
In the GP-patient relationship, the clinician holds the power which can be difficult for people who find it uncomfortable and disempowering or who have experienced trauma.
In seeking help, men feel vulnerable. To counteract this, we put clients in control as much as we can – a greater level of control than within statutory services.
They are able to decide how often they see staff, how long the care lasts, and the type of care they receive.
Al tells UNILAD Suicide Crisis even paid his bus fare when he needed to come into the Centre after his divorce left him in emotional and financial turmoil.
Understanding why men like Al choose to approach this kind of charitable establishment rather than psychiatric services can help legislators make all services more accessible.
Joy’s rationale is sevenfold, largely centred around feeling embarrassed to seek help initially – echoed by Al, who said he was waiting for an immeasurable amount of time before finally building strength to walk through the doors of the Suicide Crisis Centre, arm in arm with a cleaner who noticed him outside.
Many male clients said they wouldn’t walk into a drop-in Crisis Centre because that would mean waiting in an area with other people.
They would not have wanted anyone else to know they were coming here, and they definitely wouldn’t have wanted to risk seeing someone they knew.
So, Joy makes sure people searching for a way out of crisis comprised of small steps – someone who might not be ready for face-to-face contact straight away – can contact the Centre initially by phone, by email or text to make an appointment direct with a counsellor and given a time to visit the Suicide Crisis Centre, walk in and be seen immediately.
Al recalled how he had come across the Suicide Crisis Centre on TV, and had been so flooded with sadness he took down the email address incorrectly twice.
Laughing, and saying it ‘sounds daft’, Al said:
I sent a very brief email – just saying ‘Help’ – and Joy responded very quickly.
I tried to explain, but because I couldn’t see her, I downloaded a small, passport-sized photo of Joy off the website and put it in the top left-hand screen of my computer and I typed to her as if I was talking to her – and she responded accordingly.
From nowhere I got this great strength from her empathy.
From this moment on, only one or two members of staff are involved in the recovery process, so as to keep continuity of care and help clients feel reassured by the same friendly, non-judgemental face they trusted with whom to ‘take the hugely courageous step of expressing their deep emotional pain, their distress and their fears’.
Joy explained how this helps their high risk clients:
This may be something they have never revealed to anyone before because they have spent their adult life keeping this part of them hidden. They may only feel able to show this level of vulnerability to one member of our team.
Retrospectively, Al told UNILAD had Joy passed him to another member of the team, he wouldn’t have returned and would now be dead.
Happily, Joy’s programme design instinctively accommodated his needs and was able to return and continue his journey of recovery.
Each recovery is as different as each person who experiences suicidal thoughts, ideation and attempts to take their own life.
But one aspect of treatment at the Suicide Crisis Centre stays the same: The warm, caring, accepting, and empathic connection provided by the ever-professional team, who actively encourage people to talk to family and friends where possible.
Have you been affected by suicide? @SJMcDonn is conducting the biggest study on the emotional impact of suicide in the UK @OfficialUoM and they need your help. Fill out this anonymous survey. The more we know about suicide, the better we can prevent it.https://t.co/xsvtuWlOZt pic.twitter.com/7GKKyt1xNy
— UNILAD (@UNILAD) August 28, 2018
Joy affirmed the importance of clear boundaries, while making clients feel known rather than anonymous, especially in certain cases evoked by relationship breakdown or the death of a partner.
Here, warmth is key, she said:
In those circumstances they may feel bereft and alone, and the connection with us, and the warmth and care they receive, become very important.
Although the confidentiality of our service is important to them, they say they are not seeking an anonymous service. They want to be known to and feel connected with the people supporting them.
Other crisis services, such as Samaritans do offer confidential support, nationwide, 24 hours a day throughout the year to those going through suicide crisis.
Just by calling a number, people can get through to a trained volunteer like Rachel who’s happy to lend an ear to their pain – and thousands of outreach programmes mean Samaritans get to talk to people who are hiding their suffering in schools, businesses and beyond up and down the country.
You can watch Rachel work through a winter night shift below:
You can call Samaritans as many times as you like, speak to the volunteer on the end of the phone for as long as you like and even go and see a volunteer in person at your local branch.
The organisation continues to release reports and correlate research on suicide prevention.
The Maytree in London is a halfway house which provides respite care to people like Ben:
The Maytree fills a gap in services, offering a free four-night or five-day stay, between the medical support of the NHS and the helplines and drop-in centres of the voluntary sector.
Meanwhile, Suicide Crisis has managed to create an independent safe place for suicidal people which continues to strive to safeguard each client’s wellbeing, indefinitely.
The British government have championed the Centre as an example of best practice and The Chief Constable of the British Transport Police described Joy’s work as ‘pioneering’.
A Guardian investigation published in May 2018 found 271 highly vulnerable mental health patients died between 2012 and 2017 after 706 failings by NHS health bodies, many of whom took their own lives.
Too many people are dying under the mental health crisis teams, agrees Joy, citing figures from the University of Manchester National Confidential Inquiry which state three times as many die under their care than in psychiatric hospitals.
Indeed, Joy is contacted weekly by people who say they wish Suicide Crisis could open a Centre near them, as they can’t access treatment.
In the future, she would like to see mental health crisis teams adopting some of her methods – as well as addressing the perpetual need for more psychiatric hospital beds for people in acute mental health crises.
Al is grave as he tells us she deserves to be knighted by the constant stream of elite specialists asking to see her ‘blueprint’ for zero suicide.
Focussed on the task, Joy muses on replicating the zero suicide achievement elsewhere:
It is vital we have the right crisis services in place and people at risk of suicide can access them – and quickly. We need both the right psychiatric crisis services and the right alternatives in place.
If there was money available to create more Suicide Crisis Centres based on our model and ethos, it would surely be possible to reduce the number of deaths by suicide nationwide.
As Al describes his five-year journey in self-deprecating soft Gloucester tones, he says he’s doing ‘much better’ and proudly tells UNILAD he’s now a trustee of Suicide Crisis and has just completed his first counselling course.
A close family member of his, in their twenties, is currently in hospital after trying to take their own life. Al says Suicide Crisis have given him the strength to be a pillar for them through her recovery.
After all, every suicide is preventable. Moreover, zero suicide is possible. Al is living proof. Just ask Joy.
This week is National Suicide Prevention Week in the US. Follow UNILAD’s Suicide Prevention series every night at 8pm BST over the next week on our social channels to find out more.
If you’ve been affected by any of these issues, and want to speak to someone in confidence, please don’t suffer alone. Call Samaritans for free on their anonymous 24-hour phone line on 116 123.
In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Hotlines in other countries can be found at Suicide.org.
Save a life. Take the free suicide prevention training provided by Zero Suicide Alliance today.